Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India

  • Prashant S. Sidmal Subbaiah Institute of Medical Sciences, NH 13, Purlae, Holehonnur Road, Shimoga-577222, Karnataka, India
  • Mallikarjun HP Subbaiah Institute of Medical Sciences, NH 13, Purlae, Holehonnur Road, Shimoga-577222, Karnataka, India
  • Shekarappa KC Subbaiah Institute of Medical Sciences, NH 13, Purlae, Holehonnur Road, Shimoga-577222, Karnataka, India
Keywords: Chronic kidney disease, Echocardiography, Diastolic function, cardiovascular disease

Abstract

Objective: Our aim was to investigate whether renal insufficiency (RI) is associated with DD among patients with left ventricular ejection fraction (LVEF) > 50%, and to investigate whether there is a correlation between CKD and DD severity.

Methods: Eighty four CKD patients, aged 35-79 were examined by standard echocardiography. Subjects were divided into 4 groups depending on their estimated glomerular ?ltration rate (eGFR: ml/min/BSA) as follows: group 1 (6089 ml/min/BSA), group 2 (3059 ml/min/BSA), group 3 (1529 ml/min/BSA) and group 4 (less than 15 ml/min/BSA), between 1/2/2014 and 30/4/2015. Glomerular filtration rate (GFR) was estimated using the MDRD formula. Patients with impaired relaxation (grade I) were compared to those with pseudonormal (grade II) or restrictive (grade III-IV) DD.

Results: Among 84 patients, 23 had GFR 60-89 ml/min/BSA; 16 had GFR 30-59 ml/min/BSA; and 19 had GFR 15-30 ml/min/BSA and 26 had GFR <15 ml/min/BSA. There was a significant correlation between worsening GFR and degree of diastolic dysfunction (DD) assessed by echo. Overall, 40.4% of the participants were female, 22 (26.1 %) had grade I, & 10 (11.9 %) had grade II, 16 (19%) had grade III and 36 (42.8%) had grade IV diastolic dysfunction. Almost all patients had some degree of diastolic dysfunction. With worsening of renal function, there was worsening of diastolic dysfunction seen. In patients with end stage renal disease many had grade IV diastolic dysfunction as compared to patients with early CKD. Grade I and II DD was commonly seen in group 1 and 2. But grade III and IV DD was commonly seen in group 3 and 4.

Conclusion: Worsening renal function was associated with greater degree of diastolic dysfunction and adverse clinical outcomes. Our Study indicated a clear and independent association between RI and DD. The severity of RI also tends to correlate with the severity of DD. And that LV diastolic dysfunction was observed even in patients with early stages of chronic kidney dysfunction.

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Author Biographies

Prashant S. Sidmal, Subbaiah Institute of Medical Sciences, NH 13, Purlae, Holehonnur Road, Shimoga-577222, Karnataka, India

Associate Professor,

Department of General Medicine,

Mallikarjun HP, Subbaiah Institute of Medical Sciences, NH 13, Purlae, Holehonnur Road, Shimoga-577222, Karnataka, India

Assistant Professor,

Department of General Medicine

Shekarappa KC, Subbaiah Institute of Medical Sciences, NH 13, Purlae, Holehonnur Road, Shimoga-577222, Karnataka, India

Associate Professor,

Department of General Medicine,

Published
2015-08-30
How to Cite
1.
Sidmal P, HP M, KC S. Pattern and severity of left ventricular diastolic dysfunction in early and end stage renal disease patients with or without dialysis in rural population in South India. IJBR [Internet]. 30Aug.2015 [cited 19Nov.2018];6(8):546-53. Available from: https://ssjournals.com/index.php/ijbr/article/view/2358
Section
Original Research Articles